Tiphaine de Foucher1, Sofiane Bendifallah2, Lobna Ouldamer3, Alexandre Bricou4, Vincent Lavoue5, Justine Varinot6, Geoffroy Canlorbe1, Xavier Carcopino7, Emilie Raimond8, Laurie Monnier1, Olivier Graesslin8, Cyril Touboul9, Pierre Collinet10, Marie-Emmanuelle Neveu11, Cyrille Huchon12, Emile Daraï13, Marcos Ballester13. 1. Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), 4 rue de la Chine, 75020, Paris, France. 2. Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), 4 rue de la Chine, 75020, Paris, France; INSERM UMR_S_707, "Epidemiology, Information Systems, Modeling", University Pierre and Marie Curie, Paris 6, 27 rue de Chaligny, 75012, Paris, France. Electronic address: sofiane.bendifallah@aphp.fr. 3. Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, 2 bd Tonnellée, 37000, Tours, France. 4. Department of Obstetrics, Gynecology and Reproductive Medicine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, av du 14 juillet, 93140, Bondy, France. 5. CRLCC Eugène-Marquis, service de gynécologie, CHU de Rennes, université de Rennes 1, av de la bataille Flandres-Dunkerque, 35000, Rennes, France. 6. Department of Pathology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, 4 rue de la Chine, 75020, Paris, France. 7. Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), CNRS, IRD, chemin des Bourrely, 13105, Marseille, France. 8. Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, 45 rue Cognacq Jay, 51100, Reims, France. 9. Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, 40 av de Verdun, 94000, Créteil, France. 10. Department of Gynecologic Surgery, Jeanne de Flandre Hospital, CHU de Lille, av Eugène Avinée, 59000, Lille, France. 11. Department of Gynecology and Obstetrics, Kremlin-Bicêtre University Hospital, 78 rue du Général Leclerc, 94170, Le Kremlin-Bicêtre, France. 12. Department of Obstetrics and Gynecology, Poissy-St Germain Hospital, 10 rue du champ Gaillard, 78000, Poissy, France. 13. Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), 4 rue de la Chine, 75020, Paris, France; INSERM UMR_S_938, University Pierre et Marie Curie, Paris 6, 27 rue de Chaligny, 75012, Paris, France.
Abstract
INTRODUCTION: Evidence-based data describing patterns of recurrence and prognosis in women with FIGO stage IB2 to IIB locally advanced cervical cancer (LACC) are scarce. The purpose of this study was to analyse patterns of recurrence in LACC and their correlation with prognosis, depending on FIGO stage, lymph node (LN) status and treatment modalities. The endpoints of this study were the type of recurrence (locoregional or distant, and time to recurrence), the recurrence free survival, the overall survival and the cumulative incidence for both locoregional and distant recurrence. MATERIALS AND METHODS: Data of women with FIGO stage IB2 to IIB CC treated between April 1996 and May 2016 were retrospectively abstracted from nine French institutions. RESULTS: The median follow-up for the 501 women included was 35.6 months. Recurrences were observed in 158 (31.5%), with a mean time to recurrence of 20.7 months. Women with IIB CC had poorer prognosis, lower 3-year RFS and higher 3-year cumulative incidence of both locoregional and distant recurrences. Women with positive or unknown LN status had poorer prognosis with higher 3-year cumulative incidence of distant recurrence. Women who underwent concomitant chemo-radiotherapy ± vaginal brachytherapy had poorer prognosis, with lower 3-year RFS and higher 3-year cumulative incidence of distant recurrence. CONCLUSIONS: Recurrence location and time to recurrence differ widely depending on the FIGO stage, LN status and treatment modalities, with potential impact on follow-up modalities and therapeutic approaches.
INTRODUCTION: Evidence-based data describing patterns of recurrence and prognosis in women with FIGO stage IB2 to IIB locally advanced cervical cancer (LACC) are scarce. The purpose of this study was to analyse patterns of recurrence in LACC and their correlation with prognosis, depending on FIGO stage, lymph node (LN) status and treatment modalities. The endpoints of this study were the type of recurrence (locoregional or distant, and time to recurrence), the recurrence free survival, the overall survival and the cumulative incidence for both locoregional and distant recurrence. MATERIALS AND METHODS: Data of women with FIGO stage IB2 to IIB CC treated between April 1996 and May 2016 were retrospectively abstracted from nine French institutions. RESULTS: The median follow-up for the 501 women included was 35.6 months. Recurrences were observed in 158 (31.5%), with a mean time to recurrence of 20.7 months. Women with IIB CC had poorer prognosis, lower 3-year RFS and higher 3-year cumulative incidence of both locoregional and distant recurrences. Women with positive or unknown LN status had poorer prognosis with higher 3-year cumulative incidence of distant recurrence. Women who underwent concomitant chemo-radiotherapy ± vaginal brachytherapy had poorer prognosis, with lower 3-year RFS and higher 3-year cumulative incidence of distant recurrence. CONCLUSIONS: Recurrence location and time to recurrence differ widely depending on the FIGO stage, LN status and treatment modalities, with potential impact on follow-up modalities and therapeutic approaches.